Goel Apoorv, Kothari Shyam, Bansal Roli
Department of General Surgery, St Joseph Hospital, Ghaziabad, Uttar Pradesh, India.
Department of Medicine, Division of Nephrology, UCMS & GTB Hospital, New Delhi, India.
Euroasian J Hepatogastroenterol. 2021 Jan-Jun;11(1):11-13. doi: 10.5005/jp-journals-10018-1338.
A preferred treatment for cholelithiasis with choledocholithiasis is endoscopic retrograde cholangiopancreaticography (ERCP) followed by laparoscopic cholecystectomy (LC), which can be performed early (within 72 hours) or can be delayed for 6 to 8 weeks. This study is conducted to compare and analyze the outcome of early versus late LC following common bile duct (CBD) clearance by ERCP and determine the optimum timing for performing LC post-ERCP.
This comparative analysis was conducted at St Joseph Hospital, Ghaziabad, from September 2019 to March 2021 on 89 cases of cholelithiasis with choledocholithiasis. Patients were divided into two groups. Group I ( = 45) patients underwent early LC within 72 hours post-ERCP and group II ( = 44) patients underwent late LC after an interval of 8 weeks. Various preoperative, perioperative, and postoperative clinical parameters like operative difficulty, complications, surgery duration, hospital stay, and conversion to open cholecystectomy were analyzed.
There was no significant difference in demographic and laboratory findings in both groups. Group I patients had significantly shorter hospital stay and less operative difficulty. The duration of surgery was significantly low in group I. There was no significant difference in rate of conversion to open cholecystectomy.
Early LC post-ERCP is associated with short hospital stay and duration of surgery and less operative difficulty and complications. Therefore, we recommend that LC can be safely performed within 48 to 72 hours after ERCP.
Goel A, Kothari S, Bansal R. Comparative Analysis of Early versus Late Laparoscopic Cholecystectomy Following Endoscopic Retrograde Cholangiopancreaticography in Cases of Cholelithiasis with Choledocholithiasis. Euroasian J Hepato-Gastroenterol 2021;11(1):11-13.
胆石症合并胆总管结石的首选治疗方法是内镜逆行胰胆管造影术（ERCP），随后进行腹腔镜胆囊切除术（LC），该手术可早期（72小时内）进行，也可延迟6至8周。本研究旨在比较和分析ERCP清除胆总管（CBD）结石后早期与晚期LC的结果，并确定ERCP术后进行LC的最佳时机。
本比较分析于2019年9月至2021年3月在加济阿巴德的圣约瑟夫医院对89例胆石症合并胆总管结石患者进行。患者分为两组。第一组（n = 45）患者在ERCP术后72小时内接受早期LC，第二组（n = 44）患者在间隔8周后接受晚期LC。分析了各种术前、围手术期和术后临床参数，如手术难度、并发症、手术持续时间、住院时间以及转为开腹胆囊切除术的情况。
两组患者的人口统计学和实验室检查结果无显著差异。第一组患者的住院时间明显较短，手术难度较小。第一组的手术持续时间明显较短。转为开腹胆囊切除术的比例无显著差异。
ERCP术后早期LC与住院时间短、手术持续时间短、手术难度和并发症少有关。因此，我们建议在ERCP术后48至72小时内可安全地进行LC。
Goel A, Kothari S, Bansal R. 胆石症合并胆总管结石患者内镜逆行胰胆管造影术后早期与晚期腹腔镜胆囊切除术的比较分析。《欧亚肝脏胃肠病学杂志》2021；11(1):11 - 13。
